A common question I receive in clinical practice is about folic acid supplementation. What type of folate is best? How much should I take? Why should I take it? In 2026, this conversation has become more nuanced, with increased awareness around genetic variability, personalised nutrition, and updated public health guidance on supplementation.
Folate Vs Folic Acid: What’s The Difference
Folate is the natural form of vitamin B9 that is plentiful in dark green leafy vegetables, legumes, and cruciferous vegetables like broccoli. It is essential for DNA production, correct cell division, activating B12, reducing homocysteine levels and supporting the synthesis of SAMe for healthy mood and joints. In pregnancy, folate and other B vitamins help to reduce the risk of spinal bifida.
Folic acid is the synthetic form of folate that is often in supplements and in fortified foods such as cereals. In Australia and many other countries, mandatory folic acid fortification in staple foods continues in 2026 as a public health strategy to reduce neural tube defects.
MTHFR Gene And Folate Metabolism Explained
There is a gene, called MTHFR, that helps produce an enzyme that converts a portion of folate and folic acid into folinic acid. Folinic acid is then converted into the active form methylfolate, which is used by our cells to perform the functions mentioned above.
Advances in genetic testing have made it easier in 2026 to identify MTHFR polymorphisms, and more individuals are now aware of how this may influence their nutrient metabolism.
Folate Supplementation In Pregnancy
For those with normal MTHFR gene variants, 500mcg of folic acid is recommended to reduce the risk of spinal bifida in a growing foetus. However, if an individual has a MTHFR gene mutation, then dietary folate and folic acid supplements may not be converted to the active forms such as folinic acid and methylfolate sufficiently, which can increase the risk of birth defects, miscarriage, increased homocysteine levels and clotting. Emerging research also suggests that impaired methylation may influence mental health, detoxification pathways, and inflammatory responses.
There is debate about what form of folate should be taken in individuals with more serious MTHFR gene mutations. It is generally agreed upon that folinic acid or methylfolate (activated folates) supplementation is more suitable for those with MTHFR gene mutations as these forms have already undergone metabolism. For those with normal MTHFR gene variations, then folic acid is still suitable.
Choosing The Right Folate Supplement For Your Needs
For further information about which folate to supplement, speak to a healthcare professional who is familiar with folate metabolism and MTHFR genes. This article does not constitute health advice, always speak to your registered healthcare professional before supplementing.
References
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B.C.M (Hons), C.Clin.Prac (China), C.Toyohari. Registered Acupuncturist and Herbalist. Integrative Natural Medicine Practitioner.
Robert is a passionate and warm practitioner who has an extensive knowledge of integrative and functional natural medicine. He is down to earth and has an interest in organic foods, gardening and sustainable living. With over 17 years of experience, he is renowned for being very thorough by both fellow practitioners and patients alike.